| NPI | 1730619354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301506770) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301113025) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |